Department of Anaesthesia, Oslo University Hospital, Oslo, Norway.
Scand J Trauma Resusc Emerg Med. 2011 Apr 11;19:23. doi: 10.1186/1757-7241-19-23.
The present study was performed to compare blood product consumption and clinical results in consecutive, unselected trauma patients during the first 6 months of year 2002, 2004 and 2007.
Clinical data, blood product consumption, lowest haemoglobin values on day 1-10 after admission, and 30-day mortality were extracted from in-hospital trauma registry and the blood bank data base. The subpopulation of massively transfused patients was identified and analysed separately.
The total number of admitted trauma patients increased by 48% from 2002 to 2007, but the clinical data remained essentially unchanged. The mean number of erythrocyte units given day 1-10 decreased insignificantly from 9.4 in 2002 to 6.8 in 2007. New Injury Severity Score (NISS) increased in transfused and massively transfused patients, but not significantly. The number of patients transfused with plasma increased and the mean ratio of erythrocyte to plasma units transfused decreased by about 50%. The mean haemoglobin value in transfused patients on day 2 after admittance was significantly lower in 2007 than in 2002, while that on day 10 was significantly higher in 2007 than in 2002 and 2004. There was no change of 30-day survival from 2002 to 2007.
Significant changes of transfusion practice occurred during the past decade, probably as a result of increased focus on haemostasis and more precise criteria for transfusion. Despite a lower consumption of erythrocytes in 2007 than in 2002 and 2004, the mean haemoglobin level of transfused patients was higher on day 10 in 2007. The low number of transfused patients in this material makes evaluation of effect on survival difficult. Larger studies with strict control of all influencing factors are needed.
本研究旨在比较 2002 年、2004 年和 2007 年连续收治的创伤患者在最初 6 个月期间的血制品使用情况和临床结果。
从住院创伤登记处和血库数据库中提取临床数据、血制品使用情况、入院后第 1-10 天的最低血红蛋白值以及 30 天死亡率。此外，还单独分析了大量输血患者亚群。
2002 年至 2007 年，收治的创伤患者总数增加了 48%，但临床数据基本保持不变。第 1-10 天输注的红细胞单位数从 2002 年的 9.4 个略微减少到 2007 年的 6.8 个。接受输血和大量输血的患者的新损伤严重程度评分（NISS）增加，但无显著差异。输注血浆的患者数量增加，输注的红细胞与血浆单位数之比降低约 50%。入院后第 2 天接受输血的患者的平均血红蛋白值在 2007 年显著低于 2002 年，而第 10 天的平均血红蛋白值在 2007 年显著高于 2002 年和 2004 年。2002 年至 2007 年期间，30 天生存率没有变化。
在过去十年中，输血实践发生了重大变化，可能是由于更加关注止血和更精确的输血标准。尽管 2007 年红细胞的消耗低于 2002 年和 2004 年，但 2007 年输血患者的平均血红蛋白水平在第 10 天更高。由于本研究材料中接受输血的患者数量较少，因此评估对生存率的影响较为困难。需要进行更大规模的研究，并严格控制所有影响因素。
